Atheroma Flashcards

1
Q

Define atheroma, atherosclerosis, arteriosclerosis

A

Atheroma – The accumulation of intracellular and extracellular lipid in the intima and media of large and medium sized arteries

Atherosclerosis – The thickening and hardening of arterial walls as a consequence of atheroma

Arteriosclerosis – The thickening of the walls of arteries and arterioles, usually as a result of hypertension or diabetes mellitus

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2
Q

Describe the micro and macroscopic appearance of atheromas

A

MACRO

  • fatty streak
  • simple (raised yellow/ white) plaque
  • complicated (thrombosis, calcification) plaque

MICRO

  • smooth muscle cell proliferation
  • foam cell
  • extracellular lipid
  • fibrosis
  • necrosis
  • cholesterol clefts
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3
Q

Explain some examples of severe atherosclerosis

A
  • IHD
  • cerebral ischemia (TIA)
  • mesenteric ischemia
  • PVD
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4
Q

What are the risk factors for atheroma formation?

A
  • age
  • gender
  • hyperlipidaemia
  • cigarette smoking
  • HTN
  • DM
  • ETOH
  • infection
  • lack of exercise
  • obesity
  • oral contraceptives
  • stress
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5
Q

Describe the unifying hypothesis of atherogenesis

A
  • endothelial injury due to raised LDL, toxins, hypertension and haemodynamic stress
  • endothelial injury causes platelet adhesion, PDGF release, SMC proliferation, monocyte migration
  • foam cells secrete cytokines stimulating more SMC
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6
Q

How can you prevent atheroma?

A
  • smoking cessation
  • dietary changes
  • antihypertensives
  • manage DM
  • statin therapy
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